Purge cancer, save breasts

Hyderabad: Breast cancer treatment must be targeted towards the tumour and the breast must not be removed, the Indian Council of Medical Research has said in a consensus document where treatment modalities in one lakh cases were studied. In its document submitted to the Union ministry of health and family welfare, ICMR said breast conservation must be given priority.

There were 1,44,000 cases of breast cancer in India in 2014. Data from the document shows breast conservation rates were very low even for Stage I and Stage II of breast cancers in most of the modern cancer hospitals. A senior doctor said ICMR had come down heavily on doctors on the quality of mastectomy, dissection of the axillary lump nodes and the pathological reporting, which varied widely in different centres.

“They want the treatment to be streamlined and there must be proper protocol which must be followed by all,” he said. The ICMR also found that the choice of chemotherapy regime and hormonal agents for different stages of breast cancer was determined, apart from others, by logistics and access of the patient to the healthcare unit. A senior oncologist said the treatment regimes were different for recurrent and metastatic disease.

“This has been picked up by the evaluators and they have pointed fingers at doctors who are treating cancer patients. But every patient is different and the treatment regimes are decided on their capability to fight the disease. Uniformity can be drawn in conservation of the organs like breast and uterus where maximum care must be taken to save them if they are not severely affected by the disease,” he said.

Dr Sai Ram, senior oncologist at MNJ Cancer Hospital, said, “Saving the organs is now a priority which is being advocated across various medical forums. Treating the disease where the parts are most diseased is being emphasised and complete removal of organs is being discouraged.” The patients’ quality of life after treatment must be given absolute priority.